Lymph, There It Is: Florence Sabin, Pioneer Woman of Medical Research

For women in science, posterity has three fates in store. Some, like Marie Curie or Rosalyn Yalow, are recognized in their time and remain that way in the history books. Others, like Mary Anning or Marie Tharp, have to wait for later generations to rediscover them. And then there’s that curious third category, of women hailed as geniuses in their lives who, for some reason, we have grown to forget. Florence Sabin (1871-1953) is, sadly, one such.

While living, she was showered with accolades, and books of her life and work appeared regularly in the ensuing decades. As it stands now, however, a major biography devoted to Sabin hasn’t come out for forty long years. She broke through every barrier there was to assemble from nothing a career spanning three different areas of research, and for some reason, we’ve decided as a planet that we can’t be bothered with her any more. It’s a case of really unfathomable neglect, and it’s time we fixed it.

Florence Sabin was, plainly put, everything that is good and noble about science. She loved research, and was passionate about doing it correctly, but also recognized the world outside of the lab, devoting herself to issues of public health and education that were controversial then and still. She believed that a scientist needed to keep abreast of cultural and political developments, and made sure to arrange evenings for her students where they could listen to musicians and writers wrestling with the issues of the day.

As a person, she was admirable, and as a scientist, remarkable. She rewrote our knowledge of the lymphatic system, then shifted gears to discover unknown components of our immune response, before devoting herself to the chemistry of tuberculosis. And then, AND THEN, in her late seventies she accepted a political appointment to remake the entire state of Colorado’s health system, directly saving tens of thousands of lives with her tireless lecture appearances and public health lobbying.

That phenomenal life began like something out of a ValueTales book. Her father was intending to go into medicine when word of a gold strike in Colorado distracted him. Moving Out West, he took up work as a mine manager and met a schoolteacher from his native Vermont who was likewise a recent Colorado immigrant. They married and had two daughters in quick succession, Mary and our Florence, and then the typical Nineteenth Century Western cavalcade of horrendous tragedy rolled into town. Their next child died. Undeterred, they tried again and, after the next birth, Florence’s mother died. The resulting child lived about a year, then died. Moving in with relatives, she met her grandparents, and grew to love them, just in time for the grandmother to die. Florence Sabin was, in every way, the Luke Skywalker of mid nineteenth century science.

Her father, away from home too often to properly care for his two surviving daughters, sent them at first to a boarding school and then to live with their Uncle, who noted Florence’s gift for music and supported it. Until her junior year at the Vermont Academy, in fact, she was sure that her future was going to be that of a pianist. And then one day, as Florence was practicing, some Mean Girl (probably named Becky – they always are) strode in and asked her to play something with a melody in place of her incessant piano exercises. Florence refused, saying she needed to practice technique if she was going to be a concert performer, to which Probably Becky replied that Florence was, at best, a gifted amateur, and could never make the professional cut.

It was a dick thing to say, but probably true, and Sabin knew it. After a dark night of soul searching, she decided that she needed to devote her considerable energies to something else, and hit upon the idea of graduating college with honors, and concluded that science was the ideal place to apply her unique gifts of perseverance and curiosity. She shone in her classes and decided upon a career in medicine after hearing that Johns Hopkins, on the occasion of a sizable donation from a group of proto-feminists, had been compelled to accept women as medical students on an equal basis with men.

Unfortunately, with her father’s gold mines failing, Sabin couldn’t count on parental financial support and so, for the next three arduous years, she scrimped and saved every penny she earned through tutoring and teaching to finally buy herself an education at Johns Hopkins. It was the right decision from the first. Her instructors noted her zeal, self-direction, and flawless laboratory technique. Like Rita Levi-Montalcini a generation later, she came to the notice of her professor, Dr. Franklin Paine Mall, through the precision of her slide and staining preparations. He saw the makings of a true research scientist in her, and gave her the task of creating a new model of the midbrain for instructional purposes. Her carefully wrought model was so precise, and contained so many features as of yet unnoticed by neuroscience, that she was commissioned to change it into a book, An Atlas of the Medulla and Midbrain, which remained a standard text for years to come.

Florence Sabin was, plainly put, everything that is good and noble about science.

As important as the brain atlas was (and let’s all just appreciate that her first project was Mapping… THE BRAIN), it was Mall’s next assignment that brought her to national prominence. For a long time a controversy had raged in anatomical circles about how the lymphatic system developed, and what precisely it did. Mall set Sabin the task of meticulously studying lymphatic system formation in whatever manner she saw fit. The designing and implementing of the study was entirely her own, and for the next decade, she set about uprooting all of biology’s most cherished notions about this mysterious entity. She decided to study smaller embryos than had been used before to give her a better view of the early stages of the lymphatic system’s development, and, in a flash of insight, used India ink as the staining agent in place of the more traditional but coarser grained Berlin blue. The combination worked, and allowed her to see that, contrary to popular belief, the lymphatic system emerged from the blood vessels and spread into the intracellular space, rather than vice versa. The establishment would fight her fiercely for overthrowing their cherished doctrine, and wouldn’t hesitate to use the fact that she was a woman to try and have her data thrown out, but through careful experimentation and a refusal to be cowed, she won the day and established the basis of modern lymphatic theory.

With her work equally lauded and reviled, Sabin was already a figure of international scope before even graduating, and was given the option to either carry out a one year term at Johns Hopkins hospital, or to receive a special grant to carry on research under Dr. Mills. She felt it would be a bigger step for the cause of women in science if she accepted the hospital residency, and discovered while there how very much she didn’t want to be a medical doctor. She hated the alternation between high pressure (births and surgeries) and mechanical repetition (paperwork and prescriptions), and decided to return to research for good. Upon finishing her year, Mall fought to get her an assistantship at Johns Hopkins which turned into an associate professorship. She was his second in command, an inspiring classroom lecturer and accessible mentor to all the students, and when Mall died, she should have succeeded to his position.

Instead, the spot went to a subordinate professor who had the jolly good sense to have been born male. Sabin was offered a less prestigious full professorship in histology, but the snub rankled, and when she was offered a chance to transfer her new studies on white blood cells to the Elysian Fields of the Rockefeller Institute, she grabbed the opportunity. Leaving teaching wasn’t easy, but the chance to do fully funded research around the clock on the important problem of discovering the causes and cure for tuberculosis was irresistible. While there, she did foundation-laying work on the biochemistry of the disease, including the discovery of the fatty acid responsible for the development of tuberculosis’s tell-tale tubercles and an extension of her previous studies of monocytes, a white blood cell she had discovered while at Johns Hopkins.

Her team didn’t cure tuberculosis, but they clarified the constituents of its major features, and elements of its growth and development, which paved the way for the later drug therapies that would finally take the disease off the list of perennial American killers. Her research was cut short, firstly by mandatory retirement at the age of sixty-five, and secondly by the declining condition of her sister, Mary, which necessitated a move back to Colorado, and six mind-numbing years of retirement.

But it wasn’t the end for Sabin – gosh no! Some bright politicians in Colorado thought it would be a fine idea to appoint her to head a new department of health. After all, she was old and famous, and probably too feeble to cause much trouble. They reckoned wrong. Given purpose again, Sabin sprung into action, and uncovered the shocking state of Colorado public health. In deaths caused by the most prominent but preventable transmittable diseases of the day, it ranked consistently in the bottom five, and its record of regulating the dairy industry was nothing short of abysmal. Though nearing eighty, Sabin traveled from town to town, giving people the shocking statistics and letting them know what they could do if they wanted pure milk and uncontaminated water again. The people of Colorado loved her, and every politician who backed her health program was handily re-elected, helping her push through a serious of reforms which vastly improved the quality of life in the state.

Meanwhile, her sister’s health was failing, but Sabin didn’t have the heart to send her to a nursing home, and chose to take on the sleepless burden herself, the result being that she wrecked her own health, and Mary had to go to a nursing home anyway. Physically exhausted, Florence Sabin was checked into the hospital in 1953, there to die from a heart attack while watching her favorite team, the Brooklyn Dodgers, play the hated New York Yankees. She had penetrated the mysteries of anatomy, been friends with Gertrude Stein, given an entire state its health back, and won every accolade and degree there was to win in the medical profession, and yet the last thing she heard in this life… was that her team was down by five points.

FURTHER READING: After Sabin’s death, there were a number of good books produced trying to sum up her remarkable contributions to American medicine. 1959’s Florence Sabin: Colorado Woman of the Century by Elinor Bluemel is perhaps the most famous, but my preferred source comes ten years later, with Probing the Unknown: The Story of Dr. Florence Sabin by Mary Kay Phelan. If you have a middle schooler who is interested in scientists, it’s a great book to thrust into their hands. More recently there have been some books routinely weighing in at less than a hundred pages. Florence Sabin: Medical Researcher (1990) is a young adult title that doesn’t back down from talking about monocytes and fibrous tissues, which is nice. More recently, there’s a slim volume in the Great Lives in Colorado series devoted to her, but at 83 pages, I have my doubts. Still, if anybody out there reads it and finds it wonderful, drop me a note!

And for more awesome Women in Science comics, check out the archive and my books, Illustrated Women in Science – Volume 1, 2 and 3.

Dale DeBakcsy is the writer and artist of the Women In Science and Cartoon History of Humanism columns, and has, since 2007, co-written the webcomic Frederick the Great: A Most Lamentable Comedy with Geoffrey Schaeffer. He is also a regular contributor to The Freethinker, Philosophy Now, Free Inquiry, and Skeptical Inquirer. He studied intellectual history at Stanford and UC Berkeley before becoming a teacher of mathematics and drawer of historical frippery.